CCRN Cardiac Rhythm Interpretation and Management 2

Question 1

A hemodynamically stable patient develops sustained monomorphic ventricular tachycardia with a palpable pulse. What is the preferred first-line pharmacological intervention?

Accepted Answer

Amiodarone 150 mg IV over 10 minutes

Answer

Amiodarone 150 mg IV over 10 minutes is the first-line antiarrhythmic for stable monomorphic VT when the patient is not in cardiac arrest.

Question 2

A patient in pulseless ventricular fibrillation is identified on the monitor. What is the immediate priority intervention?

Accepted Answer

Deliver unsynchronized defibrillation

Answer

Unsynchronized defibrillation is the definitive treatment for VF and should be delivered as soon as the rhythm is identified; CPR is resumed immediately after the shock.

Question 3

Atropine 0.5 mg IV is the appropriate initial treatment for which dysrhythmia?

Accepted Answer

Symptomatic sinus bradycardia

Answer

Atropine blocks vagal tone and increases heart rate, making it first-line for symptomatic sinus bradycardia; Mobitz II typically requires pacing, not atropine.

Question 4

A patient presents with paroxysmal supraventricular tachycardia (PSVT) at 180 bpm. Vagal maneuvers have failed. What is the first pharmacological treatment of choice?

Accepted Answer

Adenosine 6 mg rapid IV push followed by a 20 mL saline flush

Answer

Adenosine 6 mg rapid IV push with a saline flush is the first-line drug for PSVT; it briefly blocks AV conduction to terminate reentrant circuits.

Question 5

A hemodynamically stable patient with atrial flutter and a ventricular rate of 150 bpm has no history of prior episodes. What is the most appropriate initial management?

Accepted Answer

Rate control with a beta-blocker or calcium channel blocker

Answer

For hemodynamically stable atrial flutter, rate control with a beta-blocker (e.g., metoprolol) or non-dihydropyridine calcium channel blocker (e.g., diltiazem) is the initial priority.

CCRN Review Practice Test

CCRN Review Practice Test

CCRN Cardiac Rhythm Interpretation and Management 2